Index case testing uptake and determinants among HIV clients attending Shashemene town public health facilities, Southern Ethiopia

Ethiopia adopted the 95-95-95 strategy as part of the National Strategic Plan to end HIV/AIDS by 2030. The HIV seronegative partners of people living with HIV, children whose parents with HIV, and families of index clients are at higher risk of contracting HIV infection. Hence, partner and family-based index testing of these groups is a key public health intervention for HIV prevention, care, and treatment. This study aims to determine the magnitude of partner and family-based index case testing of HIV and its associated factors. A facility-based cross-sectional study was conducted among randomly selected 336 HIV patients currently attending antiretroviral therapy in Shashemene Town, from February 12 to March 20, 2022. Data was collected using pre-tested interviewer-administered questionnaires. The collected data was entered into Epi-Data 3.1 and exported to SPSS version 24 for analysis. Logistic regression analyses was used to identify factors associated with family-based index case HIV testing after controlling for possible confounders. The strength of association was assessed by using an adjusted odds ratio with their corresponding confidence interval, and statistical significance was declared at a p-value < 0.05. Out of 336 respondents included in the study, the proportion of HIV-positive clients who have tested at least one family member through index case testing was 63.7% (95% CI: 58.5-69%). The odds of family-based HIV index case testing was lower among those who stayed on antiretroviral therapy for less than 1 year (AOR: 0.05, 95%CI: (0.02-0.15)], index cases who didn't disclose their HIV status to any family members [AOR: 0.06, 95%CI: (0.02-0.14)] and those having no child [AOR: 0.10, 95%CI: (0.03-0.30)]. On the other hand, for those who didn't report an incident of stigma, the odds of testing at least one family member through the index case testing strategy is about 13 times higher when compared to those who reported an incident of stigma [AOR: 13.11, 95%CI: (2.58-66.74)]. The findings revealed that the index case testing practice was relatively lower when compared to the reports from other areas and when seen through the lens of the three 95 targets. The practice of index case testing is significantly associated with HIV disclosure status, months on antiretroviral therapy, having children, and incidents of stigma. It is essential to sustain the platform of family-based index case testing service through strengthening assisted disclosure counseling, and still further work is needed to combat the stigma related to HIV status. Due focus also needs to be given to those who are newly enrolled in antiretroviral therapy.